Aspirin was invented by Bayer Inc. a little over 100 year ago.  Some of you may remember that in my previous essay  it was expected to be a small seller, compared with Bayer’s more exciting product that had such high hopes…HEROIN!   Yes…aspirin and heroin were born in the same year.

 

But you are concerned about aspirin and whether you should take one every day to prevent heart attacks and cancer to help you live longer.

 

The most recent article in the New England Journal of Medicine sheds more light on this topic and suggests that the pro’s and con’s of baby aspirin fall slightly to the negative due to the increased bleeding that results from regular low dose aspirin use.   They did not see any definitive benefits in heart attack/stroke prevention or in cancer risk to support the use of regular baby aspirin.

This issue has been controversial for many years.  In England, they have never recommended daily aspirin use due to the controversy with the data.

I think this latest study is interesting, but not the ‘nail in the coffin’ for regular aspirin use.   This study was looking at 70 year olds across the board, without specific concerns in which aspirin would test to have a more positive result.

 

So…who should take aspirin:

1.  Anyone with a history of heart disease or arrhythmia or a strong family history of heart disease.
2. Anyone on statin medications
3. Anyone with a strong family history of colon cancer, breast cancer, or prostate cancer
4. Anyone with a history of colon polyps

Who should NOT TAKE aspirin:

1.  Anyone with a history of stomach ulcer
2. Anyone with a history of bleeding issues (gastrointestinal bleeding primarily)

For the rest…it’s a toss of a coin and you could consider taking or not taking aspirin.   For today (until the next study)……if you are in the more general category, you can hold.

I have an amateur interest in aviation so I am following the MAX 8 concerns with great interest.

 

Among the issues raised with the MAX 8 is the interaction of automated technology and imperfect data input. Simply put: An excellent but completely automated system can be undone by imperfect data input, resulting in automatic ‘corrections’ that amplify the error.

 

All of us are going to be seeing these issues of interactions of expert systems in our day to day life, and how they can malfunction with small inaccuracies of input data. It is really the problem of AI (artificial intelligence) which is so very useful, but which does not provide the judgement needed to correct errors that don’t fit in standard models.

 

This is exactly what an expert internist provides. Like the most-seasoned pilot, and expert clinician has seen so many variations of ‘normal’ situations that they can ignore data that is inconsistent, trusting their judgement when crucially important, over a test results that doesn’t ‘fit’.

 

Like Will Rodgers said long ago: Good judgement comes from experience and at lot of that comes from bad judgement. My bad judgement days are behind me (read intership, residency, and my first years in practice). Although I’m in no way ‘perfect’, I am perfecting my knowledge by having an enormous volume of experiences.

 

A busy doctor is ‘practicing’ all of the time. Gaining knowledge incrementally with each encounter. Every year I see a few new things that I’ve never seen before. Integrating this into my storehouse of knowledge improves my performance with time and I know it is allowing me to ‘pilot the ship’ of medicine more ideally.

Every year the Phoenix Magazine publishes a guide featuring over 557 of the Valley’s best physicians. The doctors are selected through a peer-review survey. The theory is that medical professionals are the best qualified to judge medical professionals.

 

The survey asks the doctors to nominate those doctors who, in their judgment, are the best in their fields. Once again, Dr. Lakin has been chosen as a TOP DOC among his peers. Please join us in congratulating Dr. Lakin!

 

Statin medications are among the great discoveries of the last century, and have had a strong impact in reducing heart attack and stroke risk in the US.  Despite this, there is a grass-roots effort to discredit these medications based on the concerns that they cause a multiplicity of side effects including dementia most importantly.

 

These has been very little signal among users that these issues are developing, and to add to the scientific understanding, the American Heart Association undertook an extensive review of the literature to reassure that these medication have an overall excellent safety profile.

 

This report confirm the excellent safety record of statin medications and is consistent with my experience. These medications are safe, effective, and rarely cause side effects of concern.

 

Don’t miss out on one of the great inventions of the 20th Century. If you decide to avoid them…perhaps you should toss out your computer, cell phone, and the internet as well. Join the future of those who believe in the science….statins are safe and effective.

 

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